Carlos Raoul Reeberg, P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6440 Issued in AZ

Practice address

1017 S Gilbert Rd
Suite 104
Mesa, AZ 85204-4442

Phone

(480) 507-0130

Fax

(480) 507-0135

NPI assigned

Jan 9, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Corephysio LLC

  • Physical Therapist
  • Mesa, AZ
  • NPI 1902138431
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1114905254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 S GILBERT RD",
            "address_2": "SUITE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852044442",
            "telephone_number": "480-507-0130",
            "fax_number": "480-507-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 S GILBERT RD",
            "address_2": "SUITE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852044442",
            "telephone_number": "480-507-0130",
            "fax_number": "480-507-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEBERG",
        "first_name": "CARLOS",
        "middle_name": "RAOUL",
        "name_prefix": "Mr.",
        "credential": "P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1114905254",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reddy Gi Associates (AZ Gastro Care)
• Reddy Gi Associates
• Naresh Reddy, MD
• Sudhakar A Reddy, MD
• Adam Redner, PHARMD
• Ann Marie Reed, RDCS
• Ashley M Reed, R.PH.
• James William Reed, O.D.
• John W Reed, OD
• Kelli Atwood Reed I, P.T.A

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.